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Individual Medical Insurance (Sahatuna)
A health insurance plan that helps you deal with any sudden health adversity and high medical cost burden, Sahatuna helps you live a worry free life without compromising on your good health needs.
Features and benefits
- Age of Entry: - 14 Days to 60 Years.
- Citizens / Residents of Oman with Valid Visa for stay in Oman
- Out Patient Cover
- Cover starts after 15 days of policy issuance
- Limit for Optional Dental and Optical cover is OMR 250 (Only with Platinum Plan)
| Sahatuna- Individual Medical Insurance Policy | Bronze | Silver | Gold | Platinum | |
|---|---|---|---|---|---|
| Benefits | Inpatient and Out Patient | Yes | Yes | Yes | Yes |
| Optional Benefits | Dental and Optical (100 Omr), Dental(65 Omr) Only, Optical Only (65 Omr) | NO | NO | NO | Yes |
| Annual Limit per person | OMR 3000/- | OMR 3000/- | OMR 5000/- | ||
| OMR 5000/- | OMR 5000/- | OMR 10000/- | |||
| Hospital Network | NLGIC Designated Medical Network | Bronze Network | Band B only | Band A, Band B only excluding MPH | Band A, Band B including MPH |
| In-house pharmacy Access | Pharmacy Access within Hospital/ Clinic | No | No | Yes | Yes |
| Territorial Limit- Elective Treatment | Oman, India, Sri Lanka and Bangladesh only | Yes | Yes | Yes | Yes |
| Thailand Only | No | No | Yes | Yes | |
| Other Countries | No | Yes | Yes | Yes | |
| Territorial limit - Emergency Treatment ## | Worldwide excluding USA and Canada | Yes | Yes | Yes | Yes |
| Maximum Limit per Admission or Treatment | As per annual limit | Yes | Yes | Yes | Yes |
| Hospital Accommodation & Services | Coverage for single Private Room | Yes | Yes | Yes | Yes |
| Maximum no days per Admission or Treatment | 45 days | Yes | Yes | Yes | Yes |
| ICU | Direct Billing @agreed rates at Designated Medical Provider Network | Yes | Yes | Yes | Yes |
Consultant's, Physician's, Surgeon’s , Anaesthetist’s Fee | Direct Billing @agreed rates at Designated Medical Provider Network | Yes | Yes | Yes | Yes |
| Diagnostics (X-ray, MRI,CT Scan, Ultra Sound etc.) | Direct Billing @agreed rates at Designated Medical Provider Network | Yes | Yes | Yes | Yes |
| Laboratory | Direct Billing @agreed rates at Designated Medical Provider Network | Yes | Yes | Yes | Yes |
| Medication | Direct Billing @agreed rates at Designated Medical Provider Network | Yes | Yes | Yes | Yes |
| Physiotherapy Charges | Yes | Yes | Yes | Yes | |
| Nursing at home for recovery and in lieu of hospital stay | upto a 14 days per admission or procedure | Yes | Yes | Yes | Yes |
| Pre Existing / Chronic Condition | Not covered for 6 Months (Omr 250 Only) | Not Covered for 1st year, From 2nd Year 50% sum insured | Not Covered for 1st year, From 2nd Year 50% sum insured | Not Covered for 1st year, From 2nd Year 50% sum insured | |
| Deductible / Coinsurance | For each and every claim / visit | OMR 2 | 10% | 10% | 10% |
Transportation expense for inpatient treatment abroad | Amount per person per annum | RO 500 | RO 500 | RO 500 | RO 500 |
Maternity, Psychiatric Treatment, Congenital Hereditary and Birth Defects Treatment | Not Covered | Not Covered | Not Covered | Not Covered
| |
- Major Exclusion - All treatments within the first 15 days from the date of acceptance of the proposal by the insurer.
- Other Exclusions for 1st Year– Hernia , Hysterectomy, Hydrocele , Piles , Surgery on joints , surgery for gastric or duodenal ulcers , Sinusitis and related Disorders , Knee Replacements due to Arthritis , Hip replacements.
- Maternity and related expenses
- Drug Abuse
- Treatments arising out of racing/ hazardous activities
- As a consequence of person under the influence of any alcoholic/narcotic or drug unless administered on the advice of a physician
- Intentional self-injury while sane or insane.
- War and nuclear perils.
- Any treatment or related to HIV /AIDS
- Congenital anomalies
- Cosmetic treatments and routine medical examinations.
Wrong or incomplete information in application form may lead to rejection of claims or benefits.
- For Complaints: complaints.om@livainsurance.com or call 90163868
- For Claims: sibclaim.om@livainsurance.com or call 98883272
Terms & conditions apply
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Disclaimer: Insurance product is based on agreement with the customer and the insurance company & not the bank. Sohar International shall not be responsible for the actions or decisions of insurance company, nor shall it be liable regarding payment of claims or service under this plan.